Black Friday and end of season football games always make me think of crowds. We’ve all heard stories – people trampled to death because of panics at rock concerts, sporting events, and even Black Friday sales. The deaths are real, but the causes are wrong. In crowd crush, people usually die of asphyxiation, not from being trampled. Their chest is so compressed by the pressure of the crowd that they can’t breathe.

In addition, panic is rarely the problem. A dangerous situation may cause a crowd to attempt a quick exit, but this is appropriate, not panic. Sometimes, a limited resource (anything from the best deals to simple food and water) creates crowd crush. Most often, crowd crush is simply too many people trying to get in or out through too small an opening. At times, crush even occurs while people are standing still.

Large concert crowd. Photo by James Cridland.

People in back do not know that movement in front has stopped, so they continue to press forward. The pressure is so strong, it can bend steel railings. In addition, when people are too crowded, the mass literally acts like a fluid with waves, reflections, and turbulence. In this video of the Love Parade Concert Disaster of 2010, where 21 people died and more than 500 were injured, you can actually see the fluid waves in the crowd, beginning around 5:40 on the recording. http://www.youtube.com/watch?v=8y73-7lFBNE

How Serious Can Crowd Crush Be?

Here is a very small sampling:

December 3, 1979: 11 people killed during a crush at a concert by The Who.

July 2, 1990: A stampede in a pedestrian tunnel from Mecca led to the deaths of 1,426 pilgrims.

February 20, 2003: 100 killed in The Station nightclub fire in Rhode Island.

August 31, 2005: 953 pilgrims died in a stampede on a bridge in Baghdad, following rumors of an imminent suicide bomb attack.

August 3, 2008: At least 162 people killed and 47 injured at a temple in India when a rain shelter collapsed, mistakenly thought to be a landslide.

Fri, Nov 28, 2008: Store employee dies of asphyxiation and eleven others, including a pregnant woman, are injured on Black Friday at a Wal-Mart in New York. .

November 22, 2010: A stampede during a festival in Cambodia killed at least 347 people.

Victims of November 2010 Phnom Penh Stampede.Photo by Ramon Stoppelenburg.

What Should You Do?

What should you do? Most importantly, do anything possible to avoid crowds like these!! No concert, game, religious occurrence, or sale is worth this. If a crowd starts to form, leave. Come early or late, and wait to leave large events until crowds decrease. Even in a dangerous situation, joining the crowd will not get you out faster.

If caught in a crowd with people touching you on all 4 sides, you are in potential danger! If you feel pressure on one side, don’t push back. Move in the opposite direction if you can. Watch for swells and lulls – use lulls to move to open spaces, inching sideways and backwards from the push. Don’t panic and move slowly.

Potential Crowd Problems in Disasters

From an emergency management perspective, we must plan for potential crowds. Obviously, trained crowd management and control are essential for any large gatherings. After a disaster, however, unique crowd situations might develop around limited resources, such as overcrowded shelters, transportation for evacuation, and food/water/medicine distribution points. At hospitals, if patients with less serious injuries are turned away without plans for alternative treatment, an unruly crowd might develop. Hopefully, officials are planning for this, but my philosophy is that the more we all know, the better we’ll do.

Resources:

There is a great article by John J. Fruin called The Causes and Prevention of Crowd Disasters, which both the public and emergency planners might benefit from. Check it out: www.crowdsafe.com/FruinCauses.pdf For you rock concert fans, there is also a special page on rock concert safety at http://www.crowdsafe.com/cafe.html If any of you were ever in an uncomfortable crowd situation, leave a comment so we can all hear your experience!

I have only been in one severe crowd – the Washington DC subway after July 4 fireworks on the Mall! People kept cramming on the car, to the point where my 5 year old daughter was torn from my leg (her arms were wrapped around it), lifted off the ground and shoved away several feet, and I couldn’t lift my arms to grab her. Luckily the volume of people wasn’t high enough for a true crush, but it was still very scary.

I’m sorry that I do prefer to remain Anonymous, because I do find this topic to be very disturbing because I have personally experienced similar circumstances where crowds have gone out of control, and I have also witnessed someone being trampled, when I was a very young child. I never laugh when hearing about stampedes, and I am always angry at the fact that stampedes are mocked, laughed at, made fun of, and glorified in TV and movies, especially in children’s programming.

First, let me state that this is an extremely good and well written article, with solid advice, and well researched. This is, in fact, a wonderful article, and I salute the author! Best advice anywhere is just do NOT go to these events! I can’t agree more!

1. People DO get “trampled to death” in crowds, and in larger numbers than these NEW “theories” would like you to believe.

How can I say this with absolute certainty?

a) Because most people die from “asphyxiation,” NOT “blunt force trauma.”
b) “Asphyxiation” can also be caused by “trampling.”
c) “Stomping” can cause both “asphyxiation,” and “blunt force trauma.”
d) Trampling does NOT always leave any physical marks, such as bruises, cuts or scrapes, as one might think. See Link here: http://timesofindia.indiatimes.com/city/chennai/Woman-tramples-live-in-partner-to-death/articleshow/20950372.cms
e) In medical terms, “asphyxiation,” is a “clinical cause of death,” NOT the “physical cause.” The “physical cause” of “asphyxiation,” can NOT always be determined, and, in most cases, like these, a bit of detective work must be done to determine the “probable cause,” such as the position of the body, or if any witnesses come forward. Just as in the past, some deaths by “asphyxiation” may have been incorrectly attributed to trampling, this NEW school of thinking may cause some to incorrectly attribute the “asphyxiation” to “crowd pressure” or “crowd force,” or the idea that the victim must have been “buried under a pile of people,” where there was no pile, and where witnesses clearly state that they saw the victim being trampled with their own eyes. (In fact, “asphyxiation” was first discovered by Charles-Prosper Ollivier D’Angers in 1837, and was discovered in people who were factually known to have been trampled to death. He determined that the “clinical cause” was what would later be called “asphyxiation,” but that the “physical cause” was from being trampled.
f) Even tiny Asian women performing a walk on the back massage have to be trained and certified so that they do NOT injure the person receiving the massage. Also, in spite of the fact that most of these tiny Asian women are under 100 pounds, they are hanging onto a bar, over their heads, so that they do NOT put full body weight down on the person. In addition, the person under them is also on a cushioned table. They are NOT carelessly walking all over a man, even if he is large and muscular.
g) There have been documented cases of “murder,” in which the killer trampled the victim to death. In once such case, the official “clinical cause” of death was also “asphyxiation,” but they were stomped to death by only one individual, NOT a crowd, yet others witnessed the trampling. See link here: http://articles.philly.com/1995-04-20/news/25686187_1_mccann-prison-term-third-degree-murder

2. Stampedes and crowd crushes are NOT accidental! They are “murder!”

I do NOT mean that SOME ACCIDENTS do NOT happen, or that some epole do NOT help others, only that the entire thing itself is NOT an accident. It is a behavior of the masses, NOT every individual in the crowd, but of the masses! NOT every individual is guilty, but MOST ARE! “Pushing and shoving” are NOT involuntary actions!

It sounds like you had a horrible experience with crowds – I’m so sorry. You can never get over something like that. I agree completely that human behavior can be a major contributor to crowd injuries. However, I have been in a crowed situation where everyone was “well-behaved” – there were just too many people trying to fit in too small of space. Although luckily nothing bad happened, if just one person had tripped or stumbled, it could have been disastrous.

As a physician, my fascination with the topic is that most people assume that trampling and trauma is the cause of death, when actually asphyxiation is an even bigger threat. Death can happen without even falling down! But no matter what the medical cause is, crowd disasters are always a tragedy, and I try to avoid them however possible.

Thank you for your kind reply, and allowing me to comment on your blog.

I suppose if you can get past my emotions, I think you will see that we actually do agree.

Aside from crowd behavior, I guess my only other point was that “trampling” can also cause “asphyxiation.” So, even in the case of a death by “trampling,” the clinical cause may still be “asphyxiation.”

Regardless of the statistics, the medical cause, or even if the death was truly “accidental,” a life is a life.

Most good people in society are moved with compassion when they hear about an “accidental shooting.” Even if only one person is shot. We should all feel the same level of compassion for someone who is injured or dies in a crowd.

I also agree with you in regards to “well-behaved” crowds, in this way.

If you are one of the first to arrive, when there are only a few people, and everything is calm, things are safe.

However, if you are not aware of your surroundings, as more and more people begin to gather around you, you can suddenly find yourself “trapped” in a dangerous situation, with no means of escape.

Note that “herd mentality,” even in “well-behaved” crowds is still a “behavior,” even if things start peaceful and calm.

Also, in my experience, “panic” has NOT been the cause. “Greed, impatience, materialism and selfishness,” have always been the causes of all of the bad crowd experiences I have ever had.

I also tried to point out that there are still “Good Samaritans” left in this world, who do help people, even in crowds, and even at the risk of their own safety. That does happen.

I have also seen very cruel and deliberate acts of violence, from many people, in crowds, often just so they can get ahead in line.

In fires, I can imagine that there are people who do actually die of smoke or burns, but some of them may not have been able to escape because they had been injured by others, and were left for dead. (Again, there are still “Good Samaritans,” that would not leave someone behind, even if it cost them their own life. But, not everyone is like that.)

Once again, you are a very kind and generous person to allow me to comment on your blog, and you are a very good person to have written this blog as well.

It is evident that you genuinely care for people.

Your advice is the best, “do anything possible to avoid crowds like these!! No concert, game, religious occurrence, or sale is worth this. If a crowd starts to form, leave.”

However, I would NOT recommend coming early because that would put you “front and center,” which is one of the most dangerous positions to be in when the pushing and shoving starts.

If you have to go, better late than early.

If you must go, come late, and be the last to leave.

And, also, like you said, “Even in a dangerous situation, joining the crowd will not get you out faster.”

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Sheila Sund, M.D.

I am a physician from Salem, Oregon with a disaster fixation. Having left my previous specialties of neurology and hospice behind for now, I am instead focused on emergency preparedness, particularly healthcare response. Somehow the powers that be frequently forget that physicians will be an essential part of any response and recovery. I stick my head in everywhere to make sure we are included, and in the meantime, learn a lot about emergency response in general.
By Sheila Sund
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